[Clinical experience with sulprostone (author's transl)]

Area of Science:

• Obstetrics and Gynecology
• Pharmacology
• Reproductive Medicine

Context:

• Sulprostone (SHB 286, Schering) is a prostaglandin E2 analogue.
• This study evaluated Sulprostone's efficacy and safety for pregnancy termination.
• The study included 226 patients with missed abortion, intrauterine death, and hydatid mole.

Purpose:

• To assess the effectiveness of Sulprostone for inducing abortion across different trimesters and routes of administration.
• To compare the efficacy of intramural, intravenous, intragluteal, and extra-amniotic administration of Sulprostone.
• To determine the optimal use of Sulprostone for cervical dilation and pregnancy termination.

Summary:

• Intramural administration of Sulprostone (25-50 mcg) in the first trimester achieved an abortion score of at least 20 in 78% of patients, facilitating preoperative cervical dilation.
• In the second and third trimesters, intravenous administration yielded an 86% abortion rate, followed by extra-amniotic (74%) and intragluteal (70%) routes.
• Intravenous and intragluteal routes demonstrated better tolerance compared to the extra-amniotic route in later pregnancy stages.

Impact:

• Sulprostone is a viable option for pregnancy termination, particularly in cases of missed abortion, intrauterine death, and hydatid mole.
• The choice of administration route influences efficacy and tolerance, with intramural use beneficial for early cervical preparation and intravenous/intragluteal routes preferred for later gestations.
• Findings guide clinical decisions on Sulprostone's application for safe and effective abortion induction.